摘要
目的观察经尿道电切治疗女性原发性膀胱颈的指征及疗效。方法1988年3月-2005年8月，32例女性膀胱颈梗阻患者，平均年龄59岁，病程平均6．3年。α-受体阻滞剂治疗效果不佳，行经尿道膀胱颈电切术。术后间歇性补充尼尔雌醇2mg，每半月或1个月1次。结果32例随访6-24个月，平均15个月。术后3个月与术前最大尿流率（Qmax）分别为（25±12）mL／s和（7±9）mL／s（P〈0．05）；平均尿量分别为（403±154）mL／次和（174±152）mL／次（P〈0．05）；残余尿量分别为（70±112）mL和（355±262）mL（P〈0．05）。无尿瘘及尿失禁发生。8例肾功能不全者术后尿素氮和肌酐水平恢复正常。病检报告为膀胱颈纤维平滑肌增生，19例合并慢性炎症。结论α-受体阻滞剂治疗无效的女性原发性膀胱颈梗阻。经尿道膀胱颈电切术是安全而有效的治疗选择。间歇性补充尼尔雌醇有利于预防术后复发。
[Objective] To evaluate the efficacy of transurethral resection of the bladder neck for the treatment of primary bladder neck obstruction in women. [Methods] Between March 1988 and August 2005, thirty-two cases were included with a mean age of 59 years and symptoms lasting an average of 6. 3 years. All patients failed to respond to a-blocker. Transurethral resection of the bladder neck was performed. Estradiol was used after operation intermittently, once every 15 days or a month. [Results] All patients were followed up for 6-24 months （mean, 15 months）. The Qmax was （25±12） vs （7±9） mL per second （P 〈0.05）; the average voided volume was （403±154） vs （174±152） mL per second （P 〈0.05）; the post-void residual urine was （70±112） vs （355±262） mL （P 〈0.05） at post- operation three months and preoperation respectively. No vesicovaginal fistula and incontinence occured. The level of blood urea nitrogen and creatinine was normal after operation with 8 renal insufficiency cases. Pathology revealed leiomyofibrosis hyperplasia of the bladder neck, and 19 cases had concomitantly chronic inflammations. [Conclusions] Transurethral resection of the bladder ncek is safe and effective for the patients of female primary bladder neck obstruction who fail to respond to a-blocker. Intermittently supplement of estradiol benefits for preventing recurrences.
出处
《中国医学工程》
2007年第1期93-94,96,共3页
China Medical Engineering
关键词
膀胱颈梗阻
女性
尼尔雌醇
治疗学
bladder neck obstruction
female
estradiol
theraputics
